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Article

Liver Enhancement on Computed Tomography Is Suboptimal in Patients with Liver Steatosis

Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
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Academic Editors: Jan Philipp Radtke and Frank Vinholt Schiødt
J. Pers. Med. 2021, 11(12), 1255; https://doi.org/10.3390/jpm11121255
Received: 22 September 2021 / Revised: 15 November 2021 / Accepted: 22 November 2021 / Published: 25 November 2021
This study’s aim was twofold. Firstly, to assess liver enhancement quantitatively and qualitatively in steatotic livers compared to non-steatotic livers on portal venous computed tomography (CT). Secondly, to determine the injection volume of contrast medium in patients with severe hepatic steatosis to improve the image quality of the portal venous phase. We retrospectively included patients with non-steatotic (n = 70), the control group, and steatotic livers (n = 35) who underwent multiphase computed tomography between March 2016 and September 2020. Liver enhancement was determined by the difference in attenuation in Hounsfield units (HU) between the pre-contrast and the portal venous phase, using region of interests during in three different segments. Liver steatosis was determined by a mean attenuation of ≤40 HU on unenhanced CT. Adequate enhancement was objectively defined as ≥50 ΔHU and subjectively using a three-point Likert scale. Enhancement of non-steatotic and steatotic livers were compared and associations between enhancement and patient- and scan characteristics were analysed. Enhancement was significantly higher among the control group (mean 51.9 ± standard deviation 11.5 HU) compared to the steatosis group (40.6 ± 8.4 HU p for difference < 0.001). Qualitative analysis indicated less adequate enhancement in the steatosis group: 65.7% of the control group was rated as good vs. 8.6% of the steatosis group. We observed a significant correlation between enhancement, and presence/absence of steatosis and grams of iodine per total body weight (TBW) (p < 0.001; adjusted R2 = 0.303). Deduced from this correlation, theoretical contrast dosing in grams of Iodine (g I) can be calculated: g I = 0.502 × TBW for non-steatotic livers and g I = 0.658 × TBW for steatotic livers. Objective and subjective enhancement during CT portal phase were significantly lower in steatotic livers compared to non-steatotic livers, which may have consequences for detectability and contrast dosing. View Full-Text
Keywords: contrast media; liver; fatty liver; tomography; X-ray computed contrast media; liver; fatty liver; tomography; X-ray computed
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MDPI and ACS Style

van Cooten, V.V.; de Jong, D.J.; Wessels, F.J.; de Jong, P.A.; Kok, M. Liver Enhancement on Computed Tomography Is Suboptimal in Patients with Liver Steatosis. J. Pers. Med. 2021, 11, 1255. https://doi.org/10.3390/jpm11121255

AMA Style

van Cooten VV, de Jong DJ, Wessels FJ, de Jong PA, Kok M. Liver Enhancement on Computed Tomography Is Suboptimal in Patients with Liver Steatosis. Journal of Personalized Medicine. 2021; 11(12):1255. https://doi.org/10.3390/jpm11121255

Chicago/Turabian Style

van Cooten, Véronique V., Daan J. de Jong, Frank J. Wessels, Pim A. de Jong, and Madeleine Kok. 2021. "Liver Enhancement on Computed Tomography Is Suboptimal in Patients with Liver Steatosis" Journal of Personalized Medicine 11, no. 12: 1255. https://doi.org/10.3390/jpm11121255

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